Primary Progressive Aphasia is insidious, slowly stealing language and eventually cognition from an individual until connections to words and concepts, time and reason are strained and lost. For many years, it went undiagnosed or misdiagnosed, but with increased awareness on the part of medical professionals and consumers, now is often identified early, when aphasia is fairly young, and higher intellectual function is still intact.

Speech therapy, in my opinion, has a very important function for people with PPA: preserving identity, fostering understanding of communication, exploring strategies for maintaining self, support for those who are carers, and cementing the connections that hold us all together when things conspire to pull us apart. I am astounded by the number of people who have not had the benefit of therapy, owing to the fatalistic view of some that since the process is progressive, there is no purpose. It speaks to how limited the views can be of our role as speech-language pathologists. Yet, for every person with PPA who seeks help, and finds a bit of personhood in our clinic rooms, there is confirmation of our role, and the mutual benefit of knowledge and connection.

Today, one of my clients and his wife spoke to me about their mini-vacation with the grandchildren, one of whom is about four years old, and very attached to her “granddaddy.” Apparently, chattering away on the elevator at a huge southern hotel, she confessed to him that she needed to see someone to help her with her speech, since she has trouble making herself understood. He stared down at her, took her hand, and said, “I know. Me too.”

He is so connected to the feelings that underlie every aspect of his life, despite often being unable to discern a specific error. We can discuss his love of animals, a good film (he highly recommends “The Fighter,”) with depth and meaning, though the names of people or objects may be absent in the discussion. What he feels is his truth. And so, it becomes mine as well.

One Response to Seeing’s believing, but feeling’s the truth. Thomas Fuller

Did an internship in a focal dementia clinic that saw a lot of FTD/PPA. The first day there the neurologist was so happy to have an SLP around. He described what he called "the nihilism" that SLPs seem to have about treating PPA.